NESCOP- Neonatal Economic, Staffing and Clinical Outcomes Project

Background

Recent decades have seen significant advances in neonatal care which have led to improved survival rates for premature and sick babies. Alongside the advances in skills and technology that have led to improved survival rates, it is important to consider the impact of the resourcing of neonatal services has on babies’ outcomes. The aim of the Neonatal Economic, Staffing and Clinical Outcomes Project (NESCOP) was to establish the impact of patient volume, transfers, as well as nursing and medical staffing levels on the survival and health of premature and sick babies.

The study

Bliss part funded this study. Two papers have been published outlining some of the projects key findings. The researchers looked at what effect the level of unit and amount of care a unit was providing had on babies born very premature (born before 33 weeks gestation).The study also looked at the effect of neonatal staff levels and the amount and type of care a unit was able to provide had on the chances of survival and long term health of babies.

The research team collected information from many different sources, including the EPICure studies, unit surveys, and the information data collected by neonatal units. They were able to use this information to build a picture of what effect the number of neonatal nurses had on the survival and long term health of babies.

The findings

The research team found that a low proportion of care days during which babies were given one to one nursing in intensive care was associated with a lower chance of survival for those babies. They also found that between 2008 and 2012, the proportion of babies getting one to one care fell from about 40 per cent to just under 36 per cent. Similarly, the Bliss baby report: hanging in the balance found that only 14 per cent of neonatal units in England have enough nurses.

They also found that the average proportion of neonatal units providing one to one care in intensive care fell from nine per cent to an average of six per cent between 2008 and 2012. To find out more about this please click here.

The researchers also found that babies born before 33 weeks who were admitted onto a neonatal unit that provided high volumes of care had a better chance of survival. This effect was stronger for babies born before 27 weeks gestation.

Caroline Davey, Chief Executive of Bliss, the premature and sick baby charity said: “This research adds to a significant body of evidence that shows the importance of proper neonatal nurse staffing levels for babies’ survival, but also the distance we go to ensure that the sickest and most vulnerable babies receive the care that they deserve.”

What next?

We now have more evidence that shows just how important the provision of nursing care, as outlined in the national standards, is for the sickest babies, and how vital it is for their survival. However, the study found that further research is needed to better understand what the optimal staffing levels are for improving outcomes further, and how best to achieve this.

Bliss is campaigning for a review of funding levels for neonatal services, to address the critical staff shortages– sign our open letter to NHS England Chief Executive to give vulnerable babies a better start in life.